Gabrielle Amanda Dismuke, M.T.

Primary specialty

ContractorTaxonomy code 171W00000X

Practice address

7700 2ND Ave Ste 410
Detroit, MI 48202-2411

Phone

(313) 986-1100

Fax

(313) 338-3082

NPI assigned

Oct 16, 2013

Last updated

Oct 16, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Medical Technician

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1381881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381881600000",
    "number": "1366870990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3739 RIVARD ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482074740",
            "telephone_number": "248-785-7617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7700 2ND AVE STE 410",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022411",
            "telephone_number": "313-986-1100",
            "fax_number": "313-338-3082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISMUKE",
        "first_name": "GABRIELLE",
        "middle_name": "AMANDA",
        "name_prefix": "Ms.",
        "credential": "M.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-16",
        "last_updated": "2013-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• District Dental Center
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• Catherine Cylkowski Ditri, CSW

• Contractor in Detroit, MI
• Providers in Detroit, MI by specialty
• Contractor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.